Outcomes after Biventricular Repair Using a Conduit between the Right Ventricle and Pulmonary Artery in Infancy
Background: This study investigated the outcomes of biventricular repair using right ventricle to pulmonary artery (RV-PA) conduit placement in patients aged <1 year. Methods: Patients aged <1 year who underwent biventricular repair using an RV-PA conduit between 2011 and 2020 were included...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Society for Thoracic & Cardiovascular Surgery
2024-01-01
|
| Series: | Journal of Chest Surgery |
| Subjects: |
| _version_ | 1797365906064539648 |
|---|---|
| author | Dong Hee Jang Dong-Hee Kim Eun Seok Choi Tae-Jin Yun Chun Soo Park |
| author_facet | Dong Hee Jang Dong-Hee Kim Eun Seok Choi Tae-Jin Yun Chun Soo Park |
| author_sort | Dong Hee Jang |
| collection | DOAJ |
| description | Background: This study investigated the outcomes of biventricular repair using right
ventricle to pulmonary artery (RV-PA) conduit placement in patients aged <1 year.
Methods: Patients aged <1 year who underwent biventricular repair using an RV-PA conduit
between 2011 and 2020 were included in this study. The outcomes of interest were
death from any cause, conduit reintervention, and conduit dysfunction (peak velocity of
≥3.5 m/sec or moderate or severe regurgitation).
Results: In total, 141 patients were enrolled. The median age at initial conduit implantation
was 6 months. The median conduit diameter z-score was 1.3. The overall 5-year survival
rate was 89.6%. In the multivariable analysis, younger age (p=0.006) and longer cardiopulmonary
bypass time (p=0.001) were risk factors for overall mortality. During follow-up,
61 patients required conduit reintervention, and conduit dysfunction occurred in 68 patients.
The 5-year freedom from conduit reintervention and dysfunction rates were 52.9%
and 45.9%, respectively. In the multivariable analysis, a smaller conduit z-score (p<0.001)
was a shared risk factor for both conduit reintervention and dysfunction. Analysis of variance
demonstrated a nonlinear relationship between the conduit z-score and conduit reintervention
or dysfunction. The hazard ratio was lowest in patients with a conduit z-score
of 1.3 for reintervention and a conduit z-score of 1.4 for dysfunction.
Conclusion: RV-PA conduit placement can be safely performed in infants. A significant number
of patients required conduit reintervention and had conduit dysfunction. A slightly oversized
conduit with a z-score of 1.3 may reduce the risk of conduit reintervention or dysfunction. |
| first_indexed | 2024-03-08T16:55:37Z |
| format | Article |
| id | doaj.art-22aa4ba8cc044d1d9c187c4f6e3e8276 |
| institution | Directory Open Access Journal |
| issn | 2765-1606 2765-1614 |
| language | English |
| last_indexed | 2024-03-08T16:55:37Z |
| publishDate | 2024-01-01 |
| publisher | Korean Society for Thoracic & Cardiovascular Surgery |
| record_format | Article |
| series | Journal of Chest Surgery |
| spelling | doaj.art-22aa4ba8cc044d1d9c187c4f6e3e82762024-01-05T02:27:07ZengKorean Society for Thoracic & Cardiovascular SurgeryJournal of Chest Surgery2765-16062765-16142024-01-01571707810.5090/jcs.23.107Outcomes after Biventricular Repair Using a Conduit between the Right Ventricle and Pulmonary Artery in InfancyDong Hee Jang0https://orcid.org/0000-0002-6139-6593Dong-Hee Kim1https://orcid.org/0000-0002-4021-8712Eun Seok Choi2https://orcid.org/0000-0002-0618-4686Tae-Jin Yun3https://orcid.org/0000-0002-0336-1720Chun Soo Park4https://orcid.org/0000-0001-8718-8904University of Ulsan College of MedicineUniversity of Ulsan College of MedicineUniversity of Ulsan College of MedicineUniversity of Ulsan College of MedicineUniversity of Ulsan College of MedicineBackground: This study investigated the outcomes of biventricular repair using right ventricle to pulmonary artery (RV-PA) conduit placement in patients aged <1 year. Methods: Patients aged <1 year who underwent biventricular repair using an RV-PA conduit between 2011 and 2020 were included in this study. The outcomes of interest were death from any cause, conduit reintervention, and conduit dysfunction (peak velocity of ≥3.5 m/sec or moderate or severe regurgitation). Results: In total, 141 patients were enrolled. The median age at initial conduit implantation was 6 months. The median conduit diameter z-score was 1.3. The overall 5-year survival rate was 89.6%. In the multivariable analysis, younger age (p=0.006) and longer cardiopulmonary bypass time (p=0.001) were risk factors for overall mortality. During follow-up, 61 patients required conduit reintervention, and conduit dysfunction occurred in 68 patients. The 5-year freedom from conduit reintervention and dysfunction rates were 52.9% and 45.9%, respectively. In the multivariable analysis, a smaller conduit z-score (p<0.001) was a shared risk factor for both conduit reintervention and dysfunction. Analysis of variance demonstrated a nonlinear relationship between the conduit z-score and conduit reintervention or dysfunction. The hazard ratio was lowest in patients with a conduit z-score of 1.3 for reintervention and a conduit z-score of 1.4 for dysfunction. Conclusion: RV-PA conduit placement can be safely performed in infants. A significant number of patients required conduit reintervention and had conduit dysfunction. A slightly oversized conduit with a z-score of 1.3 may reduce the risk of conduit reintervention or dysfunction.right ventricle to pulmonary artery conduitinfancyconduit reinterventionconduit dysfunctionconduit diameter z-score |
| spellingShingle | Dong Hee Jang Dong-Hee Kim Eun Seok Choi Tae-Jin Yun Chun Soo Park Outcomes after Biventricular Repair Using a Conduit between the Right Ventricle and Pulmonary Artery in Infancy Journal of Chest Surgery right ventricle to pulmonary artery conduit infancy conduit reintervention conduit dysfunction conduit diameter z-score |
| title | Outcomes after Biventricular Repair Using a Conduit between the Right Ventricle and Pulmonary Artery in Infancy |
| title_full | Outcomes after Biventricular Repair Using a Conduit between the Right Ventricle and Pulmonary Artery in Infancy |
| title_fullStr | Outcomes after Biventricular Repair Using a Conduit between the Right Ventricle and Pulmonary Artery in Infancy |
| title_full_unstemmed | Outcomes after Biventricular Repair Using a Conduit between the Right Ventricle and Pulmonary Artery in Infancy |
| title_short | Outcomes after Biventricular Repair Using a Conduit between the Right Ventricle and Pulmonary Artery in Infancy |
| title_sort | outcomes after biventricular repair using a conduit between the right ventricle and pulmonary artery in infancy |
| topic | right ventricle to pulmonary artery conduit infancy conduit reintervention conduit dysfunction conduit diameter z-score |
| work_keys_str_mv | AT dongheejang outcomesafterbiventricularrepairusingaconduitbetweentherightventricleandpulmonaryarteryininfancy AT dongheekim outcomesafterbiventricularrepairusingaconduitbetweentherightventricleandpulmonaryarteryininfancy AT eunseokchoi outcomesafterbiventricularrepairusingaconduitbetweentherightventricleandpulmonaryarteryininfancy AT taejinyun outcomesafterbiventricularrepairusingaconduitbetweentherightventricleandpulmonaryarteryininfancy AT chunsoopark outcomesafterbiventricularrepairusingaconduitbetweentherightventricleandpulmonaryarteryininfancy |